P.124 Delayed cerebral ischemia and cognitive outcomes after aneurysmal subarachnoid hemorrhage: an exploratory analysis

Abstract

Background: Neuropsychological outcomes are an important component of the morbidity after aneurysmal subarachnoid hemorrhage (aSAH). Data on the relationship between delayed cereberal ischemia (DCI) and neuropsychological outcomes remains sparse. We herein assess the relationship between DCI and neuropsychological outcomes, as measured by the Montreal Cognitive Assessment score (MoCA) at 90 days in patients with aSAH. Methods: We performed a post-hoc analysis of the Nimodipine Microparticles to Enhance Recovery While Reducing Toxicity After Subarachnoid Hemorrhage (NEWTON-2) clinical trial. Patients were grouped based on whether they developed delayed cerebral ischemia. We assessed the relationship between MoCA scores and DCI with Student’s t-test and regression modeling. Age, sex, history of hypertension, and WFNS grade were included as covariates in the model. Results: Two-hundred and fifteen patients were included in our analysis. Mean MoCA score at 90 days in our population was 22. Mean MoCA scores were significantly lower in patients who developed DCI compared to those who did not (23.7 vs 18.4, p<0.001). Age, WFNS grade, and development of DCI were independently associated with MoCA scores in the regression model (p < 0.05). Conclusions: DCI is a predictor of decreased neuropsychological outcomes in aSAH survivors and may contribute to the morbidity burden in this population.